ATI LPN
NCLEX Practice Questions on Perioperative Care Questions
Question 1 of 5
A postoperative client has respiratory depression after receiving midazolam (Versed) for sedation. Which action by the nurse is most appropriate?
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Question 2 of 5
A hospital has been the site of an increased incidence of hospital-acquired pneumonia (HAP). What is an important measure for the prevention of HAP?
Correct Answer: B
Rationale: Preventing hospital-acquired pneumonia (HAP), a nosocomial infection occurring 48+ hours post-admission, relies on targeting vulnerable populations, making pneumococcal vaccination a key measure. This vaccine protects against Streptococcus pneumoniae, a leading HAP cause, reducing incidence in older adults or those with chronic illnesses, as supported by CDC guidelines for adults over 65 or with comorbidities. Prophylactic antibiotics aren't standard due to resistance risks and lack of evidence for broad prevention. Routine culture swabs on admission identify pathogens but don't prevent infection, serving more for treatment guidance. Antiretrovirals address HIV, not bacterial pneumonia, and aren't indicated here. Vaccination strengthens immunity in at-risk patients (e.g., elderly, immunocompromised), decreasing HAP rates, hospitalizations, and mortality, aligning with infection control priorities in healthcare settings.
Question 3 of 5
A patient in the ICU is status post embolectomy after a pulmonary embolus. What assessment parameter does the nurse monitor most closely on a patient who is postoperative following an embolectomy?
Correct Answer: D
Rationale: Post-embolectomy for pulmonary embolus (PE), the nurse most closely monitors pulmonary arterial pressure (PAP) via a pulmonary artery catheter, as it directly reflects the procedure's success in relieving pulmonary vascular obstruction. Elevated PAP pre-surgery indicates blockage; post-surgery, a decrease signals clot removal efficacy, while persistent elevation suggests residual emboli or reperfusion issues, guiding further intervention (e.g., thrombolytics). Pupillary response assesses neurological status, irrelevant unless cerebral hypoxia occurred. Vena cava pressure isn't routinely monitored and lacks specificity for PE outcomes. White blood cell differential tracks infection or inflammation, not acute hemodynamic status. PAP monitoring, alongside urinary output for perfusion, equips the nurse to detect complications (e.g., re-embolization), ensuring optimal postoperative management in this critical ICU patient.
Question 4 of 5
A nurse is completing a focused respiratory assessment of a child with asthma. What assessment finding is most closely associated with the characteristic signs and symptoms of asthma?
Correct Answer: C
Rationale: Bilateral wheezes are the assessment finding most closely tied to asthma's characteristic symptoms cough, dyspnea, and wheezing reflecting airflow obstruction from bronchospasm, inflammation, and mucus. Wheezing, a high-pitched sound on expiration (and sometimes inspiration), arises as air squeezes through narrowed airways, a hallmark audible in both lungs during an attack. Shallow respirations occur but aren't specific, lacking the obstructive quality of wheezes. Increased A-P diameter (barrel chest) develops in chronic COPD, not typically in pediatric asthma unless severe and longstanding. Bradypnea, slow breathing, contradicts asthma's tachypnea from air hunger. The nurse's detection of bilateral wheezes confirmed by auscultation guides acute management (e.g., bronchodilators), aligning with asthma's reversible, inflammatory pathophysiology in this child.
Question 5 of 5
A nurses assessment reveals that a client with COPD may be experiencing bronchospasm. What assessment finding would suggest that the patient is experiencing bronchospasm?
Correct Answer: B
Rationale: Bronchospasm in COPD, a sudden airway narrowing from smooth muscle contraction, is suggested by wheezes or diminished breath sounds on auscultation. Wheezing a high-pitched sound from turbulent airflow through constricted passages is classic, while diminished sounds reflect reduced air entry, both audible in acute exacerbation. Crackles (fine or coarse) indicate fluid or mucus, typical in pneumonia or heart failure, not bronchospasm's dry obstruction. Reduced respiratory rate or lethargy suggests severe hypoxia or fatigue, not specific to bronchospasm COPD patients often show tachypnea. Slow, deliberate respirations may be compensatory but aren't diagnostic. The nurse's detection of wheezes or diminished sounds confirmed by stethoscope prompts bronchodilator use, aligning with COPD exacerbation management to reverse this reversible component.